Individual
HENLEY FULKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1173 ROCK SPRINGS RD STE 105, SMYRNA, TN 37167-8414
(270) 314-6708
Mailing address
1173 ROCK SPRINGS RD STE 105, SMYRNA, TN 37167-8414
(270) 314-6708
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14149923
TN
235Z00000X
Speech-Language Pathologist
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Other
Enumeration date
08/23/2018
Last updated
07/23/2019
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